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Interactions amongst inflammation, renin-angiotensin-aldosterone and kallikrein-kinin systems: suggestive approaches for COVID-19 therapy

Lilian Caroline Gonçalves Oliveira1, Nayara Azinheira Nobrega Cruz1, Bruna Ricelli1, Helio Tedesco-Silva Jr.1, José Osmar Medina-Pestana1, Dulce Elena Casarini1 [ + show more ]

J Venom Anim Toxins incl Trop Dis, 2021, 27:e20200181
Received: 15 January 2021 | Accepted: 24 March 2021 | Published online: 6 December 2021
Collection: Inflammation: from bench to bedside


Coronavirus disease 2019 (COVID-19) is a rapid-spread infectious disease caused by the SARS-CoV-2 virus, which can culminate in the renin-angiotensin-aldosterone (RAAS) and kallikrein-kinin (KKS) systems imbalance, and in serious consequences for infected patients. This scoping review of published research exploring the RAAS and KKS was undertaken in order to trace the history of the discovery of both systems and their multiple interactions, discuss some aspects of the viral-cell interaction, including inflammation and the system imbalance triggered by SARS-CoV-2 infection, and their consequent disorders. Furthermore, we correlate the effects of continued use of the RAAS blockers in chronic diseases therapies with the virulence and physiopathology of COVID-19. We also approach the RAAS and KKS-related proposed potential therapies for treatment of COVID-19. In this way, we reinforce the importance of exploring both systems and the application of their components or their blockers in the treatment of coronavirus disease.


Keywords: Renin-angiotensin-aldosterone system; Kallikrein-kinin system; COVID-19; SARS-associated coronavirus; Inflammation; Coronavirus.

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